First Online: 16 November 2007Received: 01 June 2007Accepted: 16 November 2007

Abstract

BackgroundHigh blood levels of soluble urokinase Plasminogen Activator Receptor suPAR are associated with poor outcomes in human immunodeficiency-1 HIV-1 infected individuals. Research on the clinical value of suPAR in HIV-1 infection led to the development of the suPARnostic assay for commercial use in 2006. The aim of this study was to: 1 Evaluate the prognostic value of the new suPARnostic assay and 2 Determine whether polymorphisms in the active promoter of uPAR influences survival and-or suPAR values in HIV-1 patients who are antiretroviral therapy ART naive.

MethodsDNA samples were collected retrospectively from 145 Danes infected with HIV-1 with known seroconversion times. In addition, plasma was collected retrospectively from 81 of these participants for use in the suPAR analysis. Survival was analysed using Kaplan Meier analysis.

ResultsSurvival was strongly correlated to suPAR levels p < 0.001. Levels at or above 6 ng-ml were associated with death in 13 of 27 patients within a two-years period; whereas only one of 54 patients with suPAR levels below 6 ng-ml died during this period. We identified two common uPAR promoter polymorphisms: a G to A transition at -118 and an A to G transition at -465 comparative to the transcription start site. These promoter transitions influenced neither suPAR levels nor patient survival.

ConclusionPlasma suPAR levels, as measured by the suPARnostic assay, were strongly predictive of survival in ART-naïve HIV-1 infected patients. Furthermore, plasma suPAR levels were not influenced by uPAR promoter polymorphisms.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2334-7-134 contains supplementary material, which is available to authorized users.